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Organization

MEDIWEST SPECIALTY DISTRIBUTION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IBSEN TORRES (PRESIDENT)
(787) 376-4665
Entity
Organization

Contact information

Practice address
HORMIGUEROS OFFICE PARK PETROWEST PLAZA, CARR 345 KM 1.5, HORMIGUEROS, PR 00660
(787) 248-4144
(787) 966-7303
Mailing address
PO BOX 3795, MAYAGUEZ, PR 00681-3795

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
05/11/2017
Last updated
04/23/2019
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